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HomeMy WebLinkAbout4235DOCUMENT CONVERSION SERVICES PROVIDED BY IMAGING & MICROFILM ACCESS, INC. www.scanyourdocs.com 631- 589 -8100 83.81 -2 -24 BOX 32 ON ti i�g- -, T r, , IN I ' V NINE .1. 66 -.1 1 1 jo Ilk IL I 04235 . , .;� .......'m :.: y,.,.; :. : � -., , ..,",�.;.`;,,.:.,;. '; .a_, _,;, ; .. , .r• , - : "i i .'" '" _ a, r...u:'t'x•.�r r�!s � . s f ..- -a-.ro , � r+ , '';d". Zr, " h' r n � - T_sa•:. , PUTNAM COUNTY HEALTH DEPARTMENT _; b { tIVIS10N OF ENVIRONMENTAL HEALTH SERVICES P- hos)OSAOL-F.OR'SEl�� AGE TREATMENT SYST"EM'REPAiR -YES N Internal' Use Only .PERMIT # f I ❑ © Repair Permit issued in last .5 years Q Not in Watershed r ❑ Repair within Boyd's Corners, W Branch or Croton Falls Res. ©!'Delegated' ❑ Repair within 200 ft. W a watercourse or DEC-mapped wetland ❑, Joint Review SITE LOCATION (,2Z iC 14't woi . ,. TOWN ' 3`fkr" 'Q" c . c „ :. T'M,W ':3 OWNER'S NAME t : L'`). Y s u (2. i L PHONE # � i1-'W5703 4q 53 7 MAILING ADDRESS i; °,�' Icy'' 6�� iwt'�i`w s1.s; r' }�; �' �I.,1t t' APPLICANT' -Name & Relationship (i.e., owner, tenant, contr cord J i e" �( DATE i FACILITY TYPE : PCHD COMPLAINT, #.•. PROPOSED,'INSTALLER _ ; „t� �t` PHONE # ADDRESS t t'+ REGISTRATION /LICENSE # .Proposal (include a separate sketch locating the house, property lines, all`adjacent wells within 200 feet of repair and the location of existing and proposed system), NOTE: The Department may require submittal of proposal from licensed professional depending on the V nature and extent of the repair. ) :'r.IErfi - -1, 6 va”( -. � •'�.t , �j 1 e .� ' / �'r�. i N' i � t:C £r• !j r % ii s"f ' i I; as owner` agree to the conditions stated on-this form !{ SIGNAT.I.IRE T DATE F ... a�. "'(owner -O .. hL- sEptic-instalI k r -agree to -comply with the iror tditibh9 -of -hid pefiliit -fog the septic system repair , , k ''7 GiVATIKiE`F TITLE DATE f ► t (iniiialleC x Proposal approved with the following conditions: 1. Procurement of any Town Permit if applicable. V 2 Submission of as b dt repair sketch b the se tic stem installer within 3 da s of the repair, in duplicate sh in ► : p s «. Y P ..Y Q Y r ._. . a:�`'Owner's name ,S�te Sheet nd Name, Town a:- Tax'.Map number; b. Location of installed components tied to two fixed points c. System description (e.g., 1250 gal. Concrete septic tank, etc.)"'.., d. Installers', dame and phone number 3. System repair to be performed in accordance with the above proposal and conditions 4. The proposed SSTS. repair is considered a best fit design and there is no guarantee to the duration at whi the completed SSh re it will function. 5. No completed w rk ie to be backfilled until authorization to do so has been obtained from the Department., INTERNAL USE ONLY.. y. Propos 'rAppnoved . ❑ . Proposal Denied ❑ i` 1 j ,l( Inspector's Signature &Title, Date Expirafon Date t .., j t Repair proposai,is,in com liance -with applicable codes Yes O Ndeb �OPIES: PCHD; Owner; Installer PC -RP 99M Rev. 2/07 u t6k,.e Pe-CKSk-tll N..�' I CT:37 R d NJ AE 4s� C7 ./goo 9vc 14 'D VKp aD- / 3 010 ,4:p , / o' �; AR , tolati 814 1. -'END r t I �„' � � r aa$ C j�, �J�� � �n � Y"'4i"�LE tM+57"Wti 4.NE�"t"r, '�I h 7���� >M 5�� I . i; Si` 'Fib -ti \. � � � J ��, "��", . ._; ... y, -- 21 - 4 - ADVAN .CED'SEPTTC INSPECTIONS 286 Houses Corner Rd. Sparta,.M 07871 05/30/2009 Evelyn Morellis 210 Lake Drive Lake Peekskill, NY 10537 RE: 210 Lake Drive Lake Peekskill NY, 10537 Dear Evelyn Morellis: 1- 800_597 -0274 295 Princeton Hightstown Rd. Unit 168 Fax: 1 =800- 834 -2803 West Windsor; N3,08550 As requested, this company performed an inspection of the onlot wastewater system at the above noted address on 5/30/09. Attached is the report of that inspection which will document our findings. Based on the inspection, the overall system was found in "Unsatisfactory Condition." Please note that per inspection protocol, if any component of the system is found in "Unsatisfactory Condition" at the time of the inspection, the entire system is considered "Unsatisfactory" until such time as that component is repaired or replaced. - 1*6e- system--contain's- threrev main ,components: the- treatment °tank that *traps -'and -=treats--the--solids ,the° conveyance system which moves the liquid from the treatment tank to the absorption area, and the absorption area where the liquid percolates into the ground. The treatment tank was found in "Satisfacto"ry with concerns Condition." The treatment tank was opened and inspected. As requested, the treatment tank was pumped for this inspection. No cracks or leaks in the tank were noted at the time of the inspection. The baffle that directs the solids to the base of the tank (inlet baffle) was found in satisfactory condition. The baffle that prohibits floating solids from leaving the tank (outlet baffle) was found in satisfactory condition. Please note that the treatment tank is undersized for a 3 bedroom as per today's standards, this is a concern. As well the tank is steel and is prone to leaks and collapsing. This is also a concern, recommend replacement or the tank. The conveyance system was found in "Unsatisfactory Condition." Liquid leaves the treatment tank through an outlet line and enters the distribution box, which subsequently directs the effluent throughout the absorption area. This portion of the system is considered. the conveyance system. The d -box was found to be damaged (cracked) at the time of inspection and should be rep laced. M 1. Sheet l of I. PUTNAM COUNTY DEPARTMENT OF HEALTH DI-V-ISION:. 0 F-ENVIRONMENTA-1- AXLWSERMIGES-. FIELD ACTIVITY REPORT NAME Tel. A) 14 AnT)RES4:4-10 1AK-6-- 'DRiviOr _P127WAM 1/WXC5/ Street Town State Zip PERSON IN CHAR%-J.L;, nR TNTF.RVTP T).. *W-61 86"L"A &taae-s-4:: v Name and Title TYPE OF FACILITY: 5 /,jelte J A W1 M, "I Signature and Title RFP0RTRFC.F_TVFT)RV: I acknowledge receipt of this report: SIGNATURE: 02/96 Title: PU -c- H Tfk SI/ 5-f- j:O SG- [ k-A rn N ,bWe z .dwell 2, (9) p- (I loo 55'Of c '2 ?i Ei-c 4 60 6s TO 9D, PIT "eID \.J/I000 C.,4.L Pvc C-t-rA MC -o, 4; 4t,(-(q- s - FH—q3' a +k5 Av- q, #4 . %YC' 47,(o TO g in .��'��^� The liquid is directed though the d-box into m perforated pipe lines) that run out into the absorption trench. As well as a perforated tank oh\ surrounded bv stone that allows the liquid to leach into the ground. The disposal trench was located and probe holes were made. Liquid was noted above the stone in the trench back flowing into the distribution box, this is an unsatisfactory condition. The seepage pit was also located and inspected. The liquid |sva| in the pit was 0-8 inches below the inlet line prior totesting. Water was run into the seepage pit and was monitored through the pit by camera. No backup was noted and the liquid level in the pit was still 0-8 inches below the inlet line after testing. Please note that vvewere unable to access the ooapaQm pit due to location (under ramp for mhed). This Report is Not a Warranty The company provides no warranty, expressed or implied, including any warranty of the merchantability or fitness for purpose, or any other warranty whatsoever, that the system meets any code or specifications, or will function properly for any period of time. If you have any questions, okaaee do not hesitate to contact us. Thank you allowing AS| to meet your Sincerely, inspections needs. Ted Donahoe Certified Septic Inspector 'ON SITE Inspection Overview JOB NUMBER 0 Preliminary system information ® Inspection of treatment tanks S09050509 Absorption system inspection Disposal/conveyance system asessment Identification of alternative technology - requires additional investigation Client Name: Inspector Name: Ted Donahoe Evelyn Morellis Date: 5/30/09 Different From Owner? 0 Yes ❑ No ISSDS Address (including municipality): 210 Lake Drive Client Address: Lake Peekskill NY 10537 210 Lake Drive Lake Peekskill, NY 10537 Contact Method: New Jersey Coordinate: Email chrisg824@aol.com; Block: I Lot: Home Phone Was GPS used? ❑ yes Ej no Work Phone Preliminary I nformati on YES NO N/A Weather: Clear Is there a site plan or septic map available? ❑ a ❑ Last precipitation: Rain > 2 Days Is the dwelling currently occupied? Age of system: Unknown I . f so, how many occupants? 1- Type of dwelling? If no, date last occupied? Residential Number of Bedrooms: 3 If there is a mashing machine, is it connected to a separate gray water disposal system? Commercial Is the system free of additional gray water systems? -HoWm*';. ' i&�� 6ii6a-l- M-insp 6-cted-?-r YS ---'-Ii-fhddiWelrih-g-Ve-e3rdiUbbdiCp6s-aTWsTeffit r List commerical activities or high impact hobbies: Is the dwelling free of sump pump discharges to the system? None Disclosed Is the dwelling free of any historical sewage back ups into the structure? Does all sewage enter the septic system and no We of sewage bypass e)dsts? Decribe prior repair problems or repair history including soil fracturing or chemical additives. Septic Tank Pumping: Include dates and explain why the remedial Is the septic tank pumped regularly? measures were applied to the system (if Unknown available): Frequency: at some point the outlet baffle was replaced in the Date of last pumping: Unknown Was a file review completed prior to inspection? No file history on site treatment tank. Date file review requested with adimistrative authority: Comments: This inspection and report were completed in accordance with the NJDEP Onsite System Inspection Protocol posted on the NJDEP website: http#state.nj.us/dep(dwq/PdfAnspecbon_guidance.pdf 1"Freatment-Tank Type of system being inspected? Main lid opened forinspection? 0 Septic Tank ❑ Cesspool ❑ Other Liquid level below the tank's inlet invert? ❑ Liquid level below the tank's outlet invert? ❑ Other: Treatment tank pumped for this inspection? ❑ ❑ Gray water ❑ Multi- compartment: # Are all portions of the tank(s) clear of structures like a deck or a driveway? ❑ Name the material of the system? Is the area clear of evidence that sewage ❑ Concrete ❑ Block has surfaced above the treament tank? Steel ❑ Other Does water flow unimpeded from the treatment tank? ❑ Approximate Treatment Tank Volume: 500 gallons Is an effluent filter pad of the system? If yes, does it appear properly maintained? Evaluate the conditions of the tank below: Are there any other types of accessory units ❑ Satisfactory Unsatisfactory N/A present? Depth to top of tank: grade Top and Lids [a ❑ ❑ Inlet Baffle 121 ❑ ❑ Depth to top of tank access: grade Outlet Baffle Ell ❑ ❑ Comments: Cracks orLeaks Please note that the treatment tank is undersized tor a 3 bedroom as per today's Sewage Flow from standards, this is a concern. AS well the an Structure L) ❑ is steel and is prone to leaks and—WoMa—p sin q. Absorption Area: Name the type of absorption system? ❑ disposal bed lJ disposal trench seepage pit ❑ mounded ❑ cesspool ❑ other: Was the absorption system located? yes ❑ no If no, explain below in comment section. Are inspection ports present? ❑ yes no If yes, how many? the-Insp, ectiory ports checked? 'y i6 no N/A *All levels must be included -in report Was a separate probe dug to confirm observations in the inspection ports? yes ❑ no ❑N/A Is the area of the absorption system free of sewage odors? ❑ yes Ono Does sewage flow from the treatment tank to the absorption system without flowing back? ❑ yes Ono ❑N/A Is the area above or near any of the system components free from visible signs of effluent or sewage? ❑ yes 0 no Are the areas at or near the inlet invert of any absorption area component free of visible signs of Ono sewage or effluent? ❑ yes Are areas above or near system components free of lush vegitation? ❑ yes no If exposed, is the distribution box in satisfactory condition? ❑ yes no ❑N/A If not exposed, explain why not Is the area directly over any part of the system free of any evidence of large objects (cars,pools,etc.)? ❑ yes Ono Comments The disposal trench was located and probe holes were made. Liquid was noted above the stone in the trench back flowing into the distribution box, this is an unsatisfactory condition. The seepage pit was also located and inspected. The liquid level in the pit was 6-8 inches below the inlet line prior to testing. Water was run into the seepage pit and was monitored through the pit by camera. No backup was noted and the liquid level in the pit was still 6-8 inches below the inlet line after testing. Please note that we were unable to access the seepage pit due to location (under ramp for shed). Disposal tre reatment tank box Shed ge pit Satisfactory Satisfactory with Unsatisfactory House N/A Dosing or Pump Tank Disposal tre reatment tank box Shed ge pit Summary- Satisfactory Satisfactory with Unsatisfactory N/A N/A Dosing or Pump Tank Yes No Investigation Does the system contain a pump tank? Is the pump operating? DO-the *aral Is the pump elevated above the tank floor? Ell ❑ Eli Is the lid in satisfactory condition? Is the tank in satisfactory condition? ❑ Is the tank free of accumulated solids? Summary- Satisfactory Satisfactory with Unsatisfactory RequiresAddftional N/A Concerns Investigation Condition of the treatment tank(s) Condition of the conveyance and pump systems? Condition of the absorption area Condition of any accessory components ❑ Eli Comments